SHEBOYGAN SENIOR COMMUNITY INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
SHEBOYGAN SENIOR COMMUNITY INC (EIN 39-6069188)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-05-11
IRS object ID
202411329349301206
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-05-11T14:43:14-05:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line110401 W INNOVATION DR STE 300AddressLine1Txt
CityWAUWATOSACityNm
State AbbreviationWIStateAbbreviationCd
ZIP53226ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN396069188EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SHEBOYGAN SENIOR COMMUNITY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSHEBBusinessNameControlTxt
Phone9204582137PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13505 COUNTY ROAD YAddressLine1Txt
CitySHEBOYGANCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53083ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTARA HOLZEMPersonNm
Person TitleOFFICERPersonTitleTxt
Phone9204582137PhoneNum
Signature2024-05-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTARAPersonFirstNm
Person LastHOLZEMPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKRISTEN DONLEVYPreparerPersonNm
PTINP01670215PTIN
Phone4144761880PhoneNum
Preparation2024-05-02PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTARA HOLZEMPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13505 COUNTY ROAD YAddressLine1Txt
CitySHEBOYGANCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53083ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,795,362GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.SSCNONPROFIT.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1962FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee174TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$165,810PYContributionsGrantsAmt
CY Contributions Grants$660,843CYContributionsGrantsAmt
PY Program Service Revenue$8,317,192PYProgramServiceRevenueAmt
CY Program Service Revenue$9,133,570CYProgramServiceRevenueAmt
PY Investment Income$1,400PYInvestmentIncomeAmt
CY Investment Income$949CYInvestmentIncomeAmt
PY Other Revenue$183,220PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$8,667,622PYTotalRevenueAmt
CY Total Revenue$9,795,362CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,662,948PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,300,138CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,301,751PYOtherExpensesAmt
CY Other Expenses$3,024,502CYOtherExpensesAmt
PY Total Expenses$8,964,699PYTotalExpensesAmt
CY Total Expenses$9,324,640CYTotalExpensesAmt
PY Revenues Less Expenses-$297,077PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$470,722CYRevenuesLessExpensesAmt
Total Assets BOY$15,183,816TotalAssetsBOYAmt
Total Assets EOY$15,581,248TotalAssetsEOYAmt
Total Liabilities BOY$14,554,684TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,481,394TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$629,132NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,099,854NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE AND OPERATE A RETIREMENT HOME, HEALTH CARE CENTER, AND RELATED SERVICES IN THE GREATER SHEBOYGAN AREA FOR ELDERLY AND PHYSICALLY HANDICAPPED ADULTS, WHICH SHALL ENHANCE, HONOR AND PRESERVE THE DIGNITY OF THE INDIVIDUAL, AND WHERE SPIRITUAL, PHYSICAL AND SOCIAL NEEDS ARE SUPPLIED IN A SPIRIT OF CHRISTIAN LOVE AND CONCERN WITHOUT REGARD TO AGE, SEX, RACE, CREED OR COLOR.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,636,636ExpenseAmt
Revenue$9,133,570RevenueAmt
DescOPERATION OF A FULL-TIME SKILLED NURSING HOME AND RESIDENTIAL CARE CENTER. TOTAL PATIENT DAYS: 28,818.Desc
Total Program Service Expenses$7,636,636TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee174EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1TARA HOLZEMBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9204582137PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13505 CTY RD YAddressLine1Txt
CitySHEBOYGANCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53083ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
DAVID VAN DE WATER
DIRECTOR0.500.25Yes (X)$0$0$0
PERRY FRITZ
VICE CHAIRPERSON0.500.25Yes (X)$0$0$0Yes (X)
MEG TRAGER
DIRECTOR0.500.25Yes (X)$0$0$0
ERIC STUART
CHAIRPERSON0.750.25Yes (X)$0$0$0Yes (X)
CINDY THOMPSON
SECRETARY0.500.25Yes (X)$0$0$0Yes (X)
LARRY SAMET
TREASURER0.500.25Yes (X)$0$0$0Yes (X)
MALLY HENNE
DIRECTOR0.500.25Yes (X)$0$0$0
DONNA WENDLANDT
DIRECTOR0.500.25Yes (X)$0$0$0
DAMON WENIG
DIRECTOR0.500.25Yes (X)$0$0$0
TOM BRICKLEY
DIRECTOR0.500.25Yes (X)$0$0$0
BRIAN CHILDS
DIRECTOR0.500.25Yes (X)$0$0$0
CONNIE THIMMIG
DIRECTOR0.500.25Yes (X)$0$0$0
PAUL TREFFERT
CEO39.750.25$164,649$0$21,551Yes (X)
TARA HOLZEM
BUSINESS OFFICE MANAGER39.750.25$77,312$0$11,140Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$241,961TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$32,691TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Related Organizations$521,040RelatedOrganizationsAmt
Government Grants$122,336GovernmentGrantsAmt
All Other Contributions$17,467AllOtherContributionsAmt
Total Contributions$660,843TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
SKILLED NURSING FACILI623000$7,394,228$7,394,228
RESIDENTIAL CENTER623000$1,623,063$1,623,063
OTHER SERVICES623000$94,552$94,552
BEAUTY SHOP812900$20,034$20,034
INDEPENDENT LIVING623990$1,693$1,693
FieldValueIRS element (for citing)
Total Program Service Revenue$9,133,570TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$949TotalRevenueColumnAmt
Exclusion$949ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,795,362TotalRevenueColumnAmt
Related Or Exempt Func Income$9,133,570RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$949ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$274,652TotalAmt
Management And General$274,652ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,840,664TotalAmt
Program Services$4,254,492ProgramServicesAmt
Management And General$586,172ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$78,593TotalAmt
Program Services$70,450ProgramServicesAmt
Management And General$8,143ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$726,133TotalAmt
Program Services$569,811ProgramServicesAmt
Management And General$156,322ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$380,096TotalAmt
Program Services$322,321ProgramServicesAmt
Management And General$57,775ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$270TotalAmt
Management And General$270ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$24,569TotalAmt
Management And General$24,569ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$671,144TotalAmt
Program Services$507,422ProgramServicesAmt
Management And General$163,722ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$35,963TotalAmt
Management And General$35,963ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$42,135TotalAmt
Management And General$42,135ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$159,374TotalAmt
Program Services$159,374ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$436,395TotalAmt
Program Services$436,395ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$660,085TotalAmt
Program Services$541,036ProgramServicesAmt
Management And General$119,049ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$94,902TotalAmt
Program Services$94,639ProgramServicesAmt
Management And General$263ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$680,696$680,696
DUES AND SUBSCRIPTIONS$118,338$118,338
EMPLOYMENT COSTS$53,235$53,235
BAD DEBT EXPENSE$25,148$25,148

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$22,248TotalAmt
Management And General$22,248ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,324,640TotalAmt
Program Services$7,636,636ProgramServicesAmt
Management And General$1,688,004ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$509,954BOYAmt
EOY$405,064EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$337,020BOYAmt
EOY$218,037EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$522,467BOYAmt
EOY$706,875EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$44,464BOYAmt
EOY$43,857EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$107,097BOYAmt
EOY$93,351EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$17,855,614LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,551,298LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$13,662,814BOYAmt
EOY$13,304,316EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$809,748EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$15,183,816BOYAmt
EOY$15,581,248EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$466,270BOYAmt
EOY$524,219EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$108,736BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$12,615,390BOYAmt
EOY$12,299,926EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,364,288BOYAmt
EOY$1,657,249EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,554,684BOYAmt
EOY$14,481,394EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$538,908BOYAmt
EOY$1,030,381EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$90,224BOYAmt
EOY$69,473EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$629,132BOYAmt
EOY$1,099,854EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$15,183,816BOYAmt
EOY$15,581,248EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$470,722ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$16,329CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$89,080CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,195,829CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$165,810CurrentTaxYearMinus1YearAmt
Current Tax Year$660,843CurrentTaxYearAmt
Total$2,127,891TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,690,907CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,609,554CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,301,009CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,317,192CurrentTaxYearMinus1YearAmt
Current Tax Year$9,133,570CurrentTaxYearAmt
Total$40,052,232TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,707,236CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,698,634CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,496,838CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,483,002CurrentTaxYearMinus1YearAmt
Current Tax Year$9,794,413CurrentTaxYearAmt
Total$42,180,123TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$773,588CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$869,298CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$414,826CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$438,159CurrentTaxYearMinus1YearAmt
Current Tax Year$402,388CurrentTaxYearAmt
Total$2,898,259TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$773,588CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$869,298CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$414,826CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$438,159CurrentTaxYearMinus1YearAmt
Current Tax Year$402,388CurrentTaxYearAmt
Total$2,898,259TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$39,281,864PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$688CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,430CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,863CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$668CurrentTaxYearMinus1YearAmt
Current Tax Year$949CurrentTaxYearAmt
Total$6,598TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$688CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,430CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,863CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$668CurrentTaxYearMinus1YearAmt
Current Tax Year$949CurrentTaxYearAmt
Total$6,598TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$281,533CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$183,220CurrentTaxYearMinus1YearAmt
Total$464,753TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,707,924CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,700,064CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,781,234CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,666,890CurrentTaxYearMinus1YearAmt
Current Tax Year$9,795,362CurrentTaxYearAmt
Total$42,651,474TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.92100PublicSupportCY509Pct
Public Support PY5090.91540PublicSupportPY509Pct
Investment Income CY0.00020InvestmentIncomeCYPct
Investment Income PY0.00020InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME - CHANGE IN PRESENT VALUE OF DEVELOPMENT INCENTIVE RECEIVABLE - MILESTONES INCOME - 2020 AMOUNT: $ 281,533. 2021 AMOUNT: $ 183,220.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$572,217OtherCostOrOtherBasisAmt
Book Value$572,217BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,936,722OtherCostOrOtherBasisAmt
Depreciation$3,198,516DepreciationAmt
Book Value$11,738,206BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,670,549OtherCostOrOtherBasisAmt
Depreciation$1,352,782DepreciationAmt
Book Value$317,767BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$676,126OtherCostOrOtherBasisAmt
Book Value$676,126BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$13,304,316TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
FINANCING LEASE ASSETS$288,066
RIGHT TO USE ASSETS$521,682
FieldValueIRS element (for citing)
Total Book Value Other Assets$809,748TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
FINANCING LEASE LIABILITIES$292,961
DUE TO AFFILIATE$1,364,288
FieldValueIRS element (for citing)
Total Liability$1,657,249TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonPAUL TREFFERTPersonNm
TitleCEOTitleTxt
Base Compensation Filing Org$164,649BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$3,696DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$17,855NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$186,200TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationSHEBOYGAN SENIOR COMMUNITY, INC. USES DATA GATHERED FOR THEIR STATE ASSOCIATION (WISCONSIN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) BY MANAGEMENT RESOURCE ASSOCIATES (MRA), A THIRD PARTY INDEPENDENT, NOT FOR PROFIT, MANAGEMENT CONSULTING GROUP. THE DATA IS GATHERED FROM PARTICIPATING NOT FOR PROFIT HOMES THROUGHOUT THE STATE OF WISCONSIN. CLIFTONLARSONALLEN ALSO COMPLETED A COMPENSATION BENCHMARK REPORT FOR A CEO POSITION. SALARY RECOMMENDATIONS FOR THE EXECUTIVE DIRECTOR ARE REVIEWED AND SET BY THE EXECUTIVE COMMITTEE IN AN EXECUTIVE SESSION WITHOUT THE EXECUTIVE DIRECTOR'S PRESENCE AFTER THE FULL ANNUAL PERFORMANCE EVALUATION, UTILIZING THE DATA DESCRIBED ABOVE. NO OTHER MANAGEMENT STAFF ARE REVIEWED IN THIS MANNER, THOUGH ALL SALARY AND EXPENSE DATA IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD IN THEIR ANNUAL BUDGET PREPARATION AND APPROVAL.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE CHAIRPERSON, THE VICE-CHAIR, THE SECRETARY AND THE TREASURER. THE CHAIRPERSON SHALL BE THE CHAIR OF THE EXECUTIVE COMMITTEE. A QUORUM SHALL CONSIST OF THREE (3) MEMBERS. THE EXECUTIVE COMMITTEE SHALL HAVE AND MAY EXERCISE, WHEN THE BOARD OF DIRECTORS IS NOT IN SESSION, THE POWERS OF THE BOARD OF DIRECTORS IN THE MANAGEMENT OF THE AFFAIRS OF THE CORPORATION, EXCEPT ACTION IN RESPECT TO ELECTION OF BOARD OFFICERS, OFFICERS, THE FILLING OF VACANCIES IN THE BOARD OF DIRECTORS OR THE EXECUTIVE COMMITTEE, OR OTHER MATTERS SPECIFICALLY RESERVED BY THE BOARD OF DIRECTORS. THE EXECUTIVE COMMITTEE SHALL FIX ITS OWN RULES GOVERNING THE CONDUCT OF ITS ACTIVITIES AND SHALL MAKE SUCH REPORTS TO THE BOARD OF DIRECTORS OF ITS ACTIVITIES AS THE BOARD OF DIRECTORS MAY REQUEST. SECTION 5 - FINANCE COMMITTEE: SHALL BE COMPOSED OF THREE (3) BUT NO MORE THAN FIVE (5) MEMBERS, AT LEAST THREE (3) OF WHOM SHALL BE DIRECTORS. THE BOARD TREASURER SHALL BE THE CHAIR OF THE FINANCE COMMITTEE. IT SHALL BE THE DUTY OF THE COMMITTEE TO SUBMIT AT THE ANNUAL MEETING AND AT EACH MEETING OF THE BOARD OF DIRECTORS, A FINANCIAL REPORT AND ANY OTHER REPORTS AS REQUESTED BY THE BOARD OR AS DEEMED NECESSARY IN THE OPERATION OF THE CORPORATION. IN ADDITION, THE COMMITTEE SHALL, PREPARE AN ANNUAL BUDGET, SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS AND SHALL ARRANGE FOR AN INDEPENDENT AUDIT OF ALL RECEIPTS AND EXPENDITURES, SAID AUDIT TO BE DONE AT LEAST ANNUALLY AT THE CLOSE OF THE FISCAL YEAR.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PREPARED BY AN INDEPENDENT CPA WITH INFORMATION PROVIDED BY MANAGEMENT. WHEN THE FORM HAS BEEN COMPLETED, A PDF COPY OF FORM 990 IS EMAILED TO THE BUSINESS MANAGER. THE BUSINESS MANAGER FORWARDS THE EMAIL TO THE BOARD OF DIRECTORS PRIOR TO FILING THE RETURN. THE 990 IS REVIEWED BY THE BUSINESS MANAGER, CEO, AND DIRECTOR OF OPERATIONS PRIOR TO FILING. THE BUSINESS MANAGER CHECKS FORM 990 WITH INTERNAL REPORTS.
FORM 990, PART VI, SECTION B, LINE 12CEACH TRUSTEE SHALL DISCLOSE TO THE BOARD OF TRUSTEES DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST, WHENEVER THE DUALITY OR CONFLICT PERTAINS TO A MATTER BEING CONSIDERED BY THE BOARD. ANY TRUSTEE HAVING DUALITY OF INTEREST OR CONFLICT OF INTEREST ON ANY MATTER, SHALL ABSTAIN FROM VOTING ON THE MATTER AND SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE VOTE ON THE MATTER. THE MINUTES OF THE MEETING INVOLVING ANY SUCH SITUATION SHALL REFLECT THAT A DISCLOSURE WAS MADE, THE ABSTENTION FROM VOTING AND THE QUORUM SITUATION. FAILURE TO DISCLOSE DUALITY OF INTEREST OR CONFLICT OF INTEREST WHILE PARTICIPATING IN THE VOTE FOR BOARD ACTION SHALL BE REASON FOR REMOVAL FROM OFFICE. IF A TRUSTEE IS UNCERTAIN AS TO WHETHER HE OR SHE HAS A DUALITY OR CONFLICT OF INTEREST WHICH REQUIRES ABSTENTION, OR IF A TRUSTEE ASSERTS THAT ANOTHER TRUSTEE HAS SUCH DUALITY OR CONFLICT, THE BOARD, BY MAJORITY VOTE OF THOSE PRESENT, OTHER THAN THE TRUSTEE HAVING THE POSSIBLE CONFLICT, SHALL DECIDE WHETHER ABSTENTION IS REQUIRED. IF SO, THE TRUSTEE SHALL BE DEEMED TO HAVE ABSTAINED.
FORM 990, PART VI, SECTION B, LINE 15ASHEBOYGAN SENIOR COMMUNITY, INC. USES DATA GATHERED FOR THEIR STATE ASSOCIATION (WISCONSIN ASSOCIATION OF HOMES AND SERVICES FOR THE AGING) BY MANAGEMENT RESOURCE ASSOCIATES (MRA), A THIRD PARTY INDEPENDENT, NOT FOR PROFIT, MANAGEMENT CONSULTING GROUP. THE DATA IS GATHERED FROM PARTICIPATING NOT FOR PROFIT HOMES THROUGHOUT THE STATE OF WISCONSIN. CLIFTONLARSONALLEN ALSO COMPLETED A COMPENSATION BENCHMARK REPORT FOR A CEO POSITION. SALARY RECOMMENDATIONS FOR THE EXECUTIVE DIRECTOR ARE REVIEWED AND SET BY THE EXECUTIVE COMMITTEE IN AN EXECUTIVE SESSION WITHOUT THE EXECUTIVE DIRECTOR'S PRESENCE AFTER THE FULL ANNUAL PERFORMANCE EVALUATION, UTILIZING THE DATA DESCRIBED ABOVE. NO OTHER MANAGEMENT STAFF ARE REVIEWED IN THIS MANNER, THOUGH ALL SALARY AND EXPENSE DATA IS REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD IN THEIR ANNUAL BUDGET PREPARATION AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19THESE DOCUMENTS ARE AVAILABLE UPON REQUEST.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1SHEBOYGAN SENIOR COMMUNITY FOUNDATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13505 CTY RD YAddressLine1Txt
CitySHEBOYGANCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53083ZIPCd
FieldValueIRS element (for citing)
EIN391450846EIN
Primary ActivitiesRAISE/RECEIVE FUNDS TO BE USED FOR GENERAL SUPPORT OF THIS ORGANIZATIONPrimaryActivitiesTxt
Legal Domicile StateWILegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12B, IIPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1SHEBOYGAN SENIOR COMMUNITY INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgYes (1)LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SHEBOYGAN SENIOR COMMUNITY FOUNDATION INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeETransactionTypeTxt
Method Of Amount DeterminationYEAR END BALANCEMethodOfAmountDeterminationTxt

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